Kangaroo Mother Care: Skin-to-Skin Contact Guide

Kangaroo mother care (KMC) is a simple method of caring for small babies. The baby is held skin to skin on a parent’s chest for long periods, and fed breast milk often. It keeps the baby warm, calm and close to the parent.

This guide explains what KMC is, how it differs from routine skin-to-skin contact after birth, how to do it safely, and when to ask for medical help.

What is kangaroo mother care?

India’s National Health Mission describes KMC as a simple way to care for low birth weight babies that includes early and prolonged skin-to-skin contact with the mother (or another caregiver) and exclusive, frequent breastfeeding. The name comes from the way a mother kangaroo carries her baby in a pouch, where it stays warm and feeds until it is mature enough to live outside.

The method was first used in Bogota, Colombia in 1978 and came to India in 1994. The WHO formally endorsed it in 2003, according to the national training material.

KMC and routine skin-to-skin contact: the difference

The two are related but not the same. The national material makes the point clearly: KMC should not be confused with the routine skin-to-skin care that is recommended for every newborn immediately after delivery, whatever the weight.

• Routine skin-to-skin contact: given to every healthy newborn straight after birth
• Kangaroo mother care: early, continuous and prolonged skin-to-skin contact for small or low birth weight babies, with frequent breastfeeding and regular follow-up

WHO’s 2022 recommendations for preterm and low birth weight babies include starting kangaroo mother care early and starting breastfeeding early, and say mothers and babies should stay together from birth unless the baby is critically ill.

Benefits for the baby and the family

The national material lists these benefits for the newborn:

• Steadier body temperature
• Fewer illnesses and better neurodevelopment
• Earlier discharge from hospital
• More successful breastfeeding and less infection
• Closer bonding between baby and parent

A published review of KMC research found that, in settings with limited resources, KMC lowers the risk of death in stable babies born in hospital who weigh less than 2,000 grams. It also lowers the risk of low body temperature, severe illness and hospital infection, shortens hospital stay, and improves growth, breastfeeding and attachment. The authors add that the best minimum number of hours a day is still not known, and that all-day contact is not possible in most homes.

Who can give kangaroo care?

Mothers usually do it, but fathers and other healthy adult family members can too. The national material says any willing, healthy adult who follows basic hygiene can provide KMC, so grandparents and fathers can share the load while the mother rests. Good counselling at the start helps families overcome worry or old beliefs about handling a very small baby.

How to do kangaroo care at home: step by step

1. Wash your hands and wear a front-open, light top that suits your local clothing. No special dress is needed.
2. Dress the baby in a cap, socks, a nappy and a front-open sleeveless cotton garment.
3. Place the baby upright between the breasts, skin to skin, against your bare chest.
4. Position the head turned to one side and slightly extended, with the hips and arms bent (flexed).
5. Support the baby from underneath using a sling or binder, and cover both of you with your top or a wrap.
6. Feed often. Breastfeed whenever the baby shows hunger and keep the baby on your chest between feeds.

The material adds that a mother in the KMC position can walk, stand, sit and do light daily tasks. If comfortable, she can even sleep in the position with her baby.

Tip: share the sessions. Fathers and other family members can take turns so that the mother can eat, bathe and sleep.

Checking your baby during KMC

Babies in KMC should be watched regularly. The national guidance asks caregivers to check that the baby’s colour is pink and that the baby keeps a stable body temperature. Learn from the staff how to check these before you go home, and keep the follow-up dates.

When to be cautious: kangaroo care is not a replacement for medical treatment. A baby who is sick, or whose colour, breathing or temperature seems wrong, needs a doctor straight away.

Myths and facts about kangaroo care

Myth: handling a very small baby is unsafe

Fact: KMC is a recognised method used in health facilities. With teaching from the care team, families can do it safely. Fear of handling a tiny baby is common, which is why counselling is a key first step.

Myth: only mothers can do it

Fact: fathers and other healthy adult family members can give kangaroo care, which also helps them bond with the baby.

Myth: it is only for hospital use

Fact: national guidance includes discharge on KMC with regular follow-up, so the method continues at home.

Going home and follow-up

The national guidance lists signs that a baby is ready for discharge on KMC: stable, no intravenous medicine, holding temperature in room conditions on consecutive days, gaining 15 to 20 grams a day for at least three days, and feeding directly from the breast (spoon, paladai or cup are also accepted). The first follow-up is at one week and then every two weeks for two visits, with more visits until the baby reaches 40 weeks of corrected age or 2,500 grams. Community health workers (ASHAs) support families at home.

Read our guide to premature baby care and development and newborn feeding and hunger cues for related advice.

When to see a doctor

Contact your doctor or go to the nearest hospital if the baby has:

• Fast, difficult or noisy breathing, or pauses in breathing
• Skin that looks blue, grey or very pale instead of pink
• A body that feels too cold or too hot
• Poor feeding, repeated vomiting or unusual sleepiness
• Fits, stiffness or a limp body
• Weight that is not increasing as advised

Emergency care for mothers and newborns is available at any hour; see our emergency page. Our postnatal and newborn care speciality supports breastfeeding and recovery after delivery.

Talk to a doctor

If you would like help with breastfeeding, positioning or follow-up for a small baby, we can guide you. You can book an appointment or call +91 944 103 0587. This article is for general awareness and is not a substitute for a doctor's advice.